Objective: The gamma-glutamyl transpeptidase/platelet ratio (GPR) is a newly developed non-invasive serum marker of significant fibrosis and cirrhosis in patients with chronic hepatitis B (CHB) in West Africa. This study aimed to compare the diagnostic accuracy of the GPR with the aspartate aminotransferase-platelet ratio index (APRI) and with the fibrosis-4 (FIB-4) index for detecting liver fibrosis in Turkish patients with CHB.

Methods: Seventy-nine patients with CHB who had undergone liver biopsy were included, and GPR, APRI, and FIB-4 data were obtained. The receiver operating characteristic (ROC) curves and area under the ROC curves (AUROCs) were compared.

Results: As regards the fibrosis stages of 79 patients, 5 were F0 (6.3%), 17 were F1 (21.5%), 23 were F2 (29.1%), 23 were F3 (29.1%), and 11 were F4 (13.9%). The AUROCs of the GPR and APRI were similar in the diagnosis of significant fibrosis (0.70 vs. 0.69; p=0.928), advanced fibrosis (0.80 vs. 0.72; p=0.174), and cirrhosis (0.73 vs. 0.75; p=0.771) groups. The AUROCs of the GPR and FIB-4 index were similar for diagnosing significant fibrosis (0.70 vs. 0.79; p=0.090) and advanced fibrosis (0.80 vs. 0.77; p=0.569). However, the AUROCs of the FIB-4 index for diagnosing cirrhosis was significantly higher than those for the GPR (0.73 vs. 0.90; p=0.024) and APRI (0.75 vs. 0.90; p=0.024).

Conclusion: The GPR can be used to detect significant fibrosis, advanced fibrosis, and cirrhosis, but was not superior to the APRI or FIB-4 index. FIB-4 index performed better than the GPR and APRI for diagnosing cirrhosis.